[HIV infection: Which therapeutical challenges remain in 2009?]

More than 25 years after the first description of HIV, a large number of antiretroviral drugs are now available, allowing a major reduction of morbidity and mortality in most developed countries; HIV disease may be now considered as a chronic infection. However, because of the presence of provirus within infected cells totally inaccessible to drugs, treatments need to be maintained for life inducing progressively long terms secondary effects. Researches on reservoirs are a new challenge for the development of new therapeutical approaches. In resource-limited countries, where the epidemics is still going on, with the prevalence of infection that may rise 30 % in some countries such as Swaziland, access to treatments are still very limited. The development of structure including medical laboratories with trained technicians is a large challenge to transfer molecular techniques and diagnostics necessary for therapeutical follow-up of infected adults and children, as well as for the diagnosis of HIV infection in babies born to seropositive mother. French laboratories for medical virology have largely developed many molecular diagnoses for viral infections based on their experience for HIV. H1N1 is now the new challenge.